Endoscopic Management of Chronic Subdural Hematoma

Yadav, Yad Ram; Ratre, Shailendra; Parihar, Vijay; Bajaj, Jitin; Sinha, Mallika; Kumar, Amit

doi:10.1055/s-0039-1698388

Cited by 21 publications

(20 citation statements)

References 64 publications

(80 reference statements)

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“…In recent years, the endoscope-assisted evacuation of cSDH has gained traction. A mini-craniotomy or an enlarged burr hole is drilled in the skull, from which the endoscope is inserted [ 31 ]. Using direct visualization via endoscope, the drainage of cSDH becomes safer and more effective.…”

Section: Discussionmentioning

confidence: 99%

Controversies in the Surgical Treatment of Chronic Subdural Hematoma: A Systematic Scoping Review

et al. 2022

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Chronic subdural hematoma (cSDH) is one of the most common neurosurgical entities, especially in the elderly population. Diagnosis is usually established via a head computed tomography, while an increasing number of studies are investigating biomarkers to predict the natural history of cSDH, including progression and recurrence. Surgical evacuation remains the mainstay of treatment in the overwhelming majority of cases. Nevertheless, many controversies are associated with the nuances of surgical treatment. We performed a systematic review of the literature between 2010 and 2022, aiming to identify and address the issues in cSDH surgical management where consensus is lacking. The results show ambiguous data in regard to indication, the timing and type of surgery, the duration of drainage, concomitant membranectomy and the need for embolization of the middle meningeal artery. Other aspects of surgical treatment—such as the use of drainage and its location and number of burr holes—seem to have been adequately clarified: the drainage of hematoma is strongly recommended and the outcome is considered as independent of drainage location or the number of burr holes.

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Section: Discussionmentioning

confidence: 99%

Controversies in the Surgical Treatment of Chronic Subdural Hematoma: A Systematic Scoping Review

et al. 2022

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“…It results in better placement of catheter in cavity for irrigation and removal of clot and fluid. It was found to be effective for removal of CSDH especially in septate hematomas and multiloculated hematomas ( 18 ). However, there needs for special training and the extra equipment ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

The Guidewire-assisted Drainage Catheter Placement in Chronic Subdural Hematoma

et al. 2022

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BackgroundChronic subdural hematoma (cSDH) is a common neurosurgical pathology associated with older age. The burr hole drainage is a predominant technique with a lower incidence of recurrence and morbidity. The blind placement of the subdural drain could result in intracerebral hemorrhage. This paper describes a simple and reliable technique for drainage catheter placement in cSDH to reduce intracerebral hemorrhage.MethodsForty-nine consecutive patients with cSDH were treated with The Guidewire-assisted Drainage Catheter Placement Technique between July 2019 and June 2021. Epidemiological, clinical and radiographical data were collected and reviewed. The operative technique consists of an angular guidewire tip and catheter. Under the navigation of the guidewire, the catheter is inserted into the subdural space and the length of catheter remaining in the subdural space was 4–5 cm. The catheter was tunneled subcutaneously and fixed at the point where it emerged from the scalp.ResultsForty-nine consecutive patients underwent 55 The Guidewire-assisted Drainage Catheter Placement. The gender distribution was 37 men and 12 women. The mean age was 69.3 years. The patients presented with headache (31 patients), weakness of limbs (28 patients), speech disturbances (7 patients), and Altered behavior (6 patients). Neither intracerebral hemorrhages nor post-operative seizure occurred. Forty-seven patients were improved after the operation. The recurrence occurred in one patient.ConclusionsThe Guidewire-assisted Drainage Catheter Placement Technique is a reliable method for the insertion of a subdural catheter to evacuate of the Chronic Subdural Hematoma, and is associated with an extremely low risk to cortical structures and cerebral veins.

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“…Surgical intervention is required for patients with CSDH whose quality of life had been affected severely and whose symptoms continue to worsen after conservative treatments. Burr hole (single-or double-hole) craniotomy and mini-craniotomy are common procedures for CSDHs [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Time to Focus on the Scalp Incision Design for Chronic Subdural Hematoma: Technical Note and Experience

Xiao¹,

Liu²,

Gui³

et al. 2021

Preprint

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Objective: The scalp incision design in surgery for chronic subdural hematoma (CSDH) is important but is given little attention or is neglected by most neurosurgeons currently. Faulty scalp incision design will affect the ease of surgery, wound healing, and patients’ satisfaction. This study introduces the technique and experience used in our center regarding scalp incision with an adjustable question mark-shaped for CSDH procedures.Methods: A retrospective analysis was conducted of the medical records of patients with CSDH, who underwent surgical treatment that incorporated this incision design from September 2017 through December 2020. The features of concern were intraoperative scalp incision extension and postoperative wound healing. Those patients were followed for occurrences of scalp dysfunction, and their satisfaction with this design.Results: Thirty-seven patients were analyzed. For 2 patients, operative procedures were changed and scalp incisions were extended. All patients had good incision healing without complications. The outpatient or telephone follow-up 6 months after surgery revealed that 36 patients were satisfied with the scalp incision design, one patient experienced widening of incision scar. Six patients (5 women and 1 man) reported cosmetic dissatisfaction, and 7 patients (six women and one man) had mild scalp dysfunction, in daily life.Conclusion: The adjustable question mark-shaped incision used for CSDHs is a fluent curve, with a large angle, and allows a flexible extension. It ensures ease of the operative procedure, good wound healing and meeting patients’ aesthetic needs. The protocol is simple, practical, and worthy of reference by neurosurgeons, especially in primary hospitals.

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Endoscopic Management of Chronic Subdural Hematoma

Cited by 21 publications

References 64 publications

Controversies in the Surgical Treatment of Chronic Subdural Hematoma: A Systematic Scoping Review

Controversies in the Surgical Treatment of Chronic Subdural Hematoma: A Systematic Scoping Review

The Guidewire-assisted Drainage Catheter Placement in Chronic Subdural Hematoma

Time to Focus on the Scalp Incision Design for Chronic Subdural Hematoma: Technical Note and Experience

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